A 28-year-old man with no prior psychiatric history presents with acute-onset chorea, compulsive behaviors, and emotional lability three weeks after group A streptococcal pharyngitis. Vital signs: BP 118/76, HR 92, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies show elevated anti-DNase B titers. Echocardiography reveals no valvular disease. He denies recent cocaine use. Which pathophysiologic mechanism best explains his neuropsychiatric syndrome?
- A)Dopamine depletion from streptococcal toxins
- B)Autoimmune demyelination of motor tracts
- C)Viral reactivation in the substantia nigra
- D)Direct bacterial invasion of the striatum
- E)Molecular mimicry causing anti-basal ganglia antibodiesGABARITO
Explicação
Sydenham chorea is part of acute rheumatic fever, caused by molecular mimicry where streptococcal antigens cross-react with basal ganglia epitopes, triggering anti-basal ganglia antibodies. This causes chorea and behavioral changes. PANDAS (pediatric autoimmun... Ver explicação completa e trilha adaptativa →